That's why it's important not to ignore any change in the heartbeat. It could be an arrhythmia, which is at times life-threatening, cardiologists tell.

Do you feel your heart beating in your chest? If the answer is ‘no', then it's good news! “Normally, the beating of our heart doesn't even register on our minds. If you do become conscious of your heartbeat, it could be an indication of arrhythmia,” says Padma Shri awardee Dr. K. A. Abraham, Head, Department of Cardiology, Fortis Malar. The reassuring rhythm and regularity of one's heartbeat does get disturbed sometimes; this is what cardiac arrhythmia is all about. Apparently, cardiac arrhythmia affects about eight million Indians, though much of it goes undiagnosed.

Interestingly, it is an electrical activity happening right inside the heart — in the tiny, 2-3 mm wide and 10-20 mm long sinus node in the right upper chamber of the heart — that causes it to beat and pump life-giving blood to all parts of the body, which is what keeps us alive. When this electrical activity gets disoriented, the heart may beat too fast, too slow, or irregular.

“While palpitation (awareness of fast or irregular beating of the heart), is the most common symptom of arrhythmia, arrhythmia can also manifest itself through symptoms such as giddiness, breathing difficulty, loss of consciousness, general fatigue and weakness (because of inadequate blood supply),” says Dr. Abraham. In extreme cases, arrhythmia can even cause sudden death.

Who is at risk?

In the normal waking state, the adult human heart beats about 60 -100 times/per minute, though the rate can increase to about 160 beats per minute with physical exertion or emotional stress. Likewise, while sleeping, during brief periods, the heartbeat may safely drop to 30-40 beats per minute, without any adverse impact. “But if the heart beats fall to below 50 per minute on a consistent basis, even in the waking state, bradyarrhythmia is suspected; likewise, if the heart speeds up to over 100 beats per minute even without physical or emotional strain, tachyarrhythmia should be considered,” says Dr. Ragavan Subramanyan, head and director, Department of Cardiology, Frontier Lifeline.

People with structural heart diseases such as rheumatic heart disease and who have suffered heart attack, and those with hypertensive heart diseases are at risk of getting tachyarrhythmia. Other risk factors for tachyarrhythmia include inflammation of the heart, dilation and enlargement of the heart, and some congenital anomalies. “Though tachyarrhythmia can occur at any stage of life — even in the baby in the womb — more common arrhythmias occur in middle and old age. People with diabetes, lung and thyroid disease are at risk and need to be alert to arrhythmia. On the other hand, bradyarrhythmia can occur because of age-related degeneration and congenital anomalies,” says Dr. A. M. Karthigesan, consultant cardiologist and electro-physiologist, Apollo Hospitals.


Simply put, preventing heart disease does help prevent arrhythmia. So, any healthy physical practice such as moderate exercise and yoga, and adhering to a controlled diet keeps the heart healthy and reduces the chance of arrhythmia.

“After proper diagnosis, some arrhythmias are found to be mild and may not require treatment,” says Dr. Abraham. In the case of other arrhythmias such as ventricular tachycardia and ventricular fibrillation, lack of treatment can prove fatal.

Earlier, medication was the only mode of treatment for arrhythmia. Now, cardiac medicine has an array of treatment procedures to correctly diagnose, locate the focus of the arrhythmia, and target the specific area of the heart for treatment. In fact, most cases of tachycardia (when the heart beats abnormally fast) can be cured permanently by new techniques such as delivery of radiofrequency energy [RF ablation] to the site of origin of the arrhythmia. The advantage is it eliminates the need for lifelong medical therapy. For life-threatening bradyarrhythmia (abnormally slow heartbeat) patients can be treated with permanent pacemaker implantations, which helps keep the heartbeat within the normal range.

There is lack of awareness about new treatment options, making people with arrhythmia resort to lifelong medical therapy. However, with treatment, arrhythmia can be eliminated almost completely, and the person has every reason to look forward to leading a normal life, do all the things he wants to, and restore the rhythm in his life.